The Dominic Barker Trust
STANDING ORDER
Your Bank or Building Society Details
| To the Manager of | ........................................................................ | (name of your Bank or Building Society) |
| Address | ........................................................................ | |
| ........................................................................ | ||
| Postcode | ........................................................................ | |
| Name(s) of Account Holder(s) | ........................................................................ | |
| Branch Sort Code | ........................................................................ | |
| Account Number | ........................................................................ | |
| Your Address | ........................................................................ | |
| ........................................................................ | ||
| Postcode | ........................................................................ |
Instruction to your Bank or Building Society
Please pay The Dominic Barker Trust, the sum of £ ........................................................................ (amount in words)
on ........................................................................ and thereafter every month/year on the same day until otherwise notified.
| Signature(s) | ........................................................................ | |
| Date | ....................................................................... |
For Bank Use only
Please pay The Bank of Scotland plc, 35 Princes Street, Ipswich, Suffolk, IP1
1AE
Sort Code 12-16-39 for the account of The Dominic Barker Trust number 00187541.